The goal of this proposed midcareer investigator award is to expand training in patient-oriented translational research within the Pulmonary and Critical Division through enhanced mentoring and expansion of patient-oriented research program. This proposal will provide sufficient resources for Dr. Schnapp to continue to build her patient-oriented research program (examining the interface of lung injury and infection) and to insure sufficient protected time to provide more opportunities for mentoring junior faculty and fellows by integrating them into this program. It addition, it will provide the necessary protected time for Dr Schnapp's participation in additional coursework to further enhance her own development as a patient-oriented researcher. The goal of the research plan is to analyze the airspace environment during ventilator associated pneumonia (VAP) in hopes of obtaining insight into the pathogenic mechanisms of VAP, provide insight into the host response to infection in the setting of ARDS and improve the diagnosis of VAP in high-risk patients. This information may suggest new therapeutic modalities based on identified pathways, or suggest additional confirmatory diagnostic criteria for VAP. This program builds on currently funded programs, including NIH SCCOR program in Acute Lung injury, and newly funded RO1 to develop proteomic methodologies to analyze the bronchoalveolar lavage fluid during lung injury. The mentoring plan expands Dr. Schnapp's very active role in mentoring of young physicians in patient-oriented research and her leadership role in developing a curriculum in translational research for trainees. The research and mentoring program will take advantage of outstanding resources and infrastructure at the University of Washington, including long standing interactions of the Pulmonary Division with the School of Public Health, existing K30 and K12 programs, and state-of- the-art proteomic facilities. The University of Washington provides an outstanding setting for collaborative training and patient-oriented research in Pulmonary Medicine.